Revive Pelvic Health & Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REVIVE PELVIC HEALTH & PHYSICAL THERAPY LLC

Doing business as

Revive Pelvic Health and Physical Therapy

Practice address

107 Victoria LN
Clinton, MS 39056-4031

Phone

(601) 953-6876

NPI assigned

Feb 8, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Veronica Barton, PT

Title

Ceo

Phone

(601) 953-6876

Specialties & licenses 2

Addresses

Other names 2

• Revive Pelvic Health and Physical Therapy Doing business as
• Revive Pelvic Health and Physical Therapy, LLC Other name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Veronica Woodson

  • Physical Therapist
  • Jackson, MS
  • NPI 1508346222
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1689266009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 VICTORIA LN",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564031",
            "telephone_number": "601-953-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 VICTORIA LN",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564031",
            "telephone_number": "601-953-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PELVIC HEALTH & PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-953-6876",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Pelvic Health and Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Revive Pelvic Health and Physical Therapy, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kendra Maria Redding, FNP-C
• Kathryn Reeves
• Reliable Hands LLC
• Reliablehands LLC
• William C Renfrow
• Reynolds Cardiology PLLC
• Amy Nicole Reynolds
• Ashley Rhoads, PHARMD
• Christina Rhodes-Fleming
• Scott Whitten Rhodes, DPT

• Physical Therapy Clinic/Center in Clinton, MS
• Providers in Clinton, MS by specialty
• Physical Therapy Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.